Benjamin T O'Connell, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

UO 2893 Issued in FL

Practice address

2627 Riverside Ave
Jacksonville, FL 32204-4712

Phone

(904) 308-7372

Fax

(904) 308-2908

NPI assigned

Jun 27, 2011

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, GA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

Nova Southeastern College of Osteo Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Vincent'S Ambulatory Care IncGroup PAC ID 2860411188, 303 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health Home health agency, Waycross, GA, CCN 117076

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: benjamin.o.connell.1@8967.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St Vincents Ambulatory Care Inc

  • Neurological Surgery Physician
  • Jacksonville, FL
  • NPI 1417987124

  GA

  Medicare reassignment Care Compare group NPD
• St Vincents Ambulatory Care Inc

  • Durable Medical Equipment & Medical Supplies
  • Jacksonville, FL
  • NPI 1679226690
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Amedisys Georgia, L.L.C.

  • Home Health Agency
  • Waycross, GA
  • NPI 1316120322
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309132800000",
    "number": "1386930493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2627 RIVERSIDE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044712",
            "telephone_number": "904-308-7372",
            "fax_number": "904-308-2908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2627 RIVERSIDE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044712",
            "telephone_number": "904-308-7372",
            "fax_number": "904-308-2908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNELL",
        "first_name": "BENJAMIN",
        "middle_name": "T",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-27",
        "last_updated": "2011-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "UO 2893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick O'Brien, LMHC
• Stacie Dee O'Brien
• Tara O'Brien, BCABA
• Whitney O'Brien, RD
• Agatha O'Connell
• Florence Marie-Louise O'Connell, M.D.
• Jada Ireon O'Conner
• Alexandra O'Connor, MSW
• Bobbie Jean O'Connor, LMHC
• Brett Daniel O'Connor, O.D.

• Family Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.